Tobacco sales and marketing within 100 yards of schools in Ahmedabad City, India

Summary

Objectives

The Government of India passed the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003 (COPTA 2003), which prohibits the sale of tobacco products within 100 yards of educational institutions and regulates tobacco advertising. The aim of this research was to monitor compliance with the section of COPTA 2003 regarding the advertisement, display and sale of tobacco products around educational institutions in Ahmedabad City, India.

Study design

Observational study around 30 randomly selected schools.

Methods

In March 2010, an observational study was conducted to assess compliance with COPTA 2003 in Ahmedabad City, India. All vendors within a 100-yard radius of 30 randomly selected schools were identified. At locations where tobacco was sold, information was collected regarding type of product sold, sale of tobacco in single units and advertising.

Results

Twenty public schools and 10 private schools were sampled. Of these, 87% [n = 26, 95% confidence interval (CI) 69–95%] had tobacco sales within 100 yards of their entrance. Of the 771 vendors observed, 24% (n = 185, 95% CI 18–32%) sold tobacco products. Tobacco advertising in violation of the law was found around 57% of schools (n = 17, 95% CI 39–73%), product displays around 83% of schools (n = 25, 95% CI 65–93%) and single sales around 70% of schools (n = 21, 95% CI 51–84%).

Conclusions

Violation of the sections of COPTA 2003 regarding sale of tobacco products around educational institutions and advertising in general is widespread in Ahmedabad City, India. Effective enforcement of the existing law is necessary to protect the children in India from widespread exposure to the sale and marketing of tobacco products.

Introduction

Tobacco advertising at the point of sale has become increasingly important for tobacco companies as governments begin to restrict advertising through other avenues.1, 2, 3, 4, 5, 6 Young people are particularly vulnerable to the effects of tobacco advertising. Among youth, exposure to tobacco marketing not only fosters acceptance of smoking, but also increases positive perceptions of individuals using the advertised brand. Exposure to tobacco advertising increases perceived ease of access, as well as perceived prevalence of tobacco use among their peers. Most importantly, exposure to tobacco advertising results in an increase in both the intention as well as the actual initiation of tobacco use among youth.⁷

Article 13 of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) addresses the importance of regulating the efforts of the tobacco industry to market tobacco products as a key strategy to decrease tobacco use.⁸ In order to assist FCTC signatories in implementing the requirements of the treaty, WHO developed the MPOWER package in 2008, which focuses on policies that reduce demand-side measures of tobacco control. Monitoring tobacco use and prevention policies and enforcing bans on tobacco advertising, promotion and sponsorship are two key components of the MPOWER strategy. Although many countries have implemented advertising restrictions, lack of enforcement remains a key impediment to their success. According to the WHO, among the 26 countries with comprehensive tobacco advertising, promotion and sponsorship bans, only three high-income and four low-income countries have been able to ensure high compliance with their laws.⁹

A ratifying party of the FCTC, the Government of India passed comprehensive tobacco control legislation, the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003 (COPTA 2003). In addition to tobacco control measures such as smoke-free public places and graphic pack warnings, COPTA 2003 places strict regulations on the advertisement, display and sale of tobacco products. Tobacco products are not to be sold within 100 yards of the perimeter of any educational institution, and in other locations where tobacco sales are allowed, strict advertising restrictions apply. Specifically, advertisements should not exceed 60 cm by 45 cm in size, and should contain, in an appropriate Indian language, one of two approved health warnings (‘Tobacco causes cancer’ or ‘Tobacco kills’). Advertisements are not allowed to have a brand, brand pack shot or any other promotional message or picture, and may only list the types of tobacco products that are available at that location. In addition, regardless of the location of the vendor, retailers may not display tobacco products, ‘in such a way that they are visible so as to prevent easy access of tobacco products to persons below the age of 18 years’.¹⁰

While the regulations imposed by COPTA 2003 are strict, effective enforcement and compliance with the law is necessary to ensure a beneficial public health impact. The aim of this study was to monitor compliance in Ahmedabad City, India with the section of COPTA 2003 regarding the advertisement, display and sale of tobacco products around educational institutions.